CN103974676B - Utilize under the inner membrance of biological absorbable support the most logical - Google Patents
Utilize under the inner membrance of biological absorbable support the most logical Download PDFInfo
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- CN103974676B CN103974676B CN201280060585.5A CN201280060585A CN103974676B CN 103974676 B CN103974676 B CN 103974676B CN 201280060585 A CN201280060585 A CN 201280060585A CN 103974676 B CN103974676 B CN 103974676B
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- distally
- balloon structure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
- A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22094—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
- A61B2017/22095—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing accessing a blood vessel true lumen from the sub-intimal space
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
- A61F2002/0086—Special surfaces of prostheses, e.g. for improving ingrowth for preferentially controlling or promoting the growth of specific types of cells or tissues
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
- A61F2002/9583—Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0194—Tunnelling catheters
- A61M2025/0197—Tunnelling catheters for creating an artificial passage within the body, e.g. in order to go around occlusions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
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- Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Surgery (AREA)
- Cardiology (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Ophthalmology & Optometry (AREA)
- Otolaryngology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
A kind of heavily lead to conduit tube component for walk around that the obturation in blood vessel sets up inner membrance underpass.Heavily lead to conduit tube component and there is the inflatable formula balloon structure (20) including distally anchor portion (60), this distally anchor portion is configured to launch in the true luminal part of the blood vessel in inaccessible distally, with the period grappling heavily admittance pipe that launches in inner membrance underpass at support in order to avoid accidental movement.Expandable type support (40) such as biological absorbable support may be configured to promote the natural tissues regrowth around support, to produce the shallow-layer theca interna along inner membrance underpass.
Description
Cross-Reference to Related Applications
The application advocates to enjoy the power of the U.S. Provisional Patent Application the 61/568,903rd of December in 2011 submission on the 9th
Benefit, the complete disclosure of this application is herein incorporated by reference.
Technical field
Present disclosure is for the heavily logical device and method for inaccessible blood vessel.More specifically, present disclosure pin
To in space under the inner membrance of the generation for support being positioned at blood vessel to form the inaccessible part that gets around the true tube chamber of blood vessel
The device and method of path.
Background technology
Chronic total occlusion (CTO) be hinder blood flow through vascular arterial block, and may be present in coronary artery and
In both peripheral arterials.In some instances it is difficult to medical treatment device maybe can not be utilized through CTO to make vascular along direct motion direction
The most logical.Thus, have been developed over for walking around the inaccessible inner membrance underpass that produces (that is, in internal film tissue's layer and the adventitia group of vascular
Path between tissue layer) and then enter back in inaccessible distally in the true tube chamber of vascular to scheme the technology making vascular heavily lead to.Cause
This, it is desirable to alternative heavy exchange device and/or method that the blood vessel making to exist CTO is heavily logical are provided.
Summary of the invention
Present disclosure is for manufacturing medical treatment device structure and some alternative design, material and the method for assembly, and makes
With.
Therefore, one exemplary embodiment is heavily to lead to conduit set for what the obturation walking around in blood vessel set up inner membrance underpass
Part.Heavily lead to conduit tube component and include from the elongated catheter shaft that hub assembly is distally extending, and be arranged on the distal part of catheter shaft
On inflatable formula balloon structure.Inflatable formula balloon structure is configured to utilize fluid to be expanded to inflation structure from structure of releasing,
This fluid is delivered to the inside of inflatable formula balloon structure via the inflation tube chamber extending through catheter shaft.Support holds inflatable
The body part of formula balloon structure, the distally anchor portion of the most inflatable formula balloon structure is positioned at the distally of support.Can fill
The distally anchor portion of expanding balloon structure is configured to launch, with at support in the true luminal part of the blood vessel in inaccessible distally
The period grappling weight admittance pipe launched in inner membrance underpass is in order to avoid accidental movement.
Another one exemplary embodiment is by walking around the method that obturation sets up inner membrance underpass to make blood vessel heavily lead to.The party
Method includes initially entering between the distal openings of tube wall in the proximal open of tube wall of inaccessible nearside and the inaccessible distally of entrance
Produce inner membrance underpass.Expandable type support is positioned in inner membrance underpass, and then expandable type support at inner membrance underpass
Middle expansion.Hereafter, promote that natural tissues regrowth is to produce shallow-layer (or surface) theca interna along inner membrance underpass around support.
Another one exemplary embodiment is by walking around the method that obturation sets up inner membrance underpass to make blood vessel heavily lead to.The party
Method includes initially entering between the distal openings of tube wall in the proximal open of tube wall of inaccessible nearside and the inaccessible distally of entrance
Produce inner membrance underpass.The expandable type support of the body part holding inflatable formula balloon structure is positioned at inner membrance underpass
In, in the true luminal part of the blood vessel that the distally anchor portion of the most inflatable formula balloon structure is positioned at inaccessible distally.Can
Then the distally anchor portion of expansion type balloon structure inflates in the true luminal part in inaccessible distally, and inflatable formula sacculus
The body part of structure is through inflating so that expandable type support launches in inner membrance underpass.The distally anchor portion grappling of inflation
Inflatable formula balloon structure is in order to avoid unexpected nearside moves, and support launches to keep support suitably to put in inner membrance underpass simultaneously
Put in inner membrance underpass.
Some exemplary embodiments outlined above is not intended to describe each disclosed embodiment or present disclosure
Enforcement in terms of each.
Accompanying drawing explanation
It is considered in conjunction with the accompanying the described in detail below of various embodiment, the aspect of present disclosure can be more fully understood from,
In the accompanying drawings:
Fig. 1 is the side plan view of the exemplary catheter equipment heavily led to for blood vessel；
Fig. 2 is the side plan view of the constructive alternative of the distal part of the catheter device of Fig. 1；
Fig. 3 is the side plan view of another constructive alternative of the distal part of the catheter device of Fig. 1；
Fig. 4 to Fig. 8 shows the side for the illustrative methods using the catheter device of Fig. 1 to make inaccessible blood vessel heavily lead to
Face；And
Fig. 8 A is the cross sectional view of the line 8A-8A intercepting along Fig. 8, it is shown that include the false tube chamber of shallow-layer theca interna.
Although the aspect of present disclosure can carry out various remodeling and alterative version, but its details is the most by way of example
Shown in the drawings and will be described in detail.It is to be understood, however, that this is not intended to be limited to the aspect of present disclosure
Described specific embodiment.On the contrary, this be intended to cover fall in the spirit and scope of present disclosure all remodeling, etc. Tongfang
Case and alternate ways.
Detailed description of the invention
For the term hereafter limited, these will be applied to define, unless in the claims or in the other places of this specification
Provide different definition.
All numerical value are the most substantially pointed out all to take as being modified by term " about ".Term " about " is usual
Representing a digital scope, those skilled in the art will be considered to this scope and is equal to described value and (that is, has identical function or knot
Really).In many cases, term " about " is represented by the numeral including being rounded to immediate significant figure.
The digital scope recorded by end points include all numerals within the range (such as, 1 to 5 include 1,1.5,2,
2.75,3,3.80,4 and 5).
Although disclosing some size, scope and/or the values being suitable for belonging to various component, feature and/or specification, but this
The technical staff in field passes through the guidance of present disclosure it will be appreciated that desired size, scope and/or value can deviate the openest
These.
As used by the specification and the appended claims, singulative " ", " one " and " being somebody's turn to do " include that plural number is right
As, unless its content clearly dictates.As used by the specification and the appended claims, term " or " generally with it
Including " and/or " implication use, unless its content clearly dictates.
The accompanying drawing that should refer to described in detail below is read, and wherein the similar components label in different figures is identical.Describe in detail
Depict one exemplary embodiment with the accompanying drawing being not necessarily to scale and be not intended to limit the scope of the disclosure.The demonstration drawn
Property embodiment is intended merely as exemplary.The selected feature of any one exemplary embodiment all may be incorporated in additional embodiment,
Unless the contrary clearly pointed out.
Exemplary weight admittance pipe 10 is shown at Fig. 1.The weight admittance pipe 10 being shown as stent delivery catheter can include dominating
Pipe axle 12, its hub assembly 14 at the near-end 16 of catheter shaft 12 extends to extendable members, and this extendable members is shown as can fill
Expanding balloon structure 20, it is arranged on the nearside of the far-end 18 being positioned at catheter shaft 12 in the distal part of catheter shaft 12.At some
In the case of, catheter shaft 12 or its can include, in the portions of proximal of balloon structure 20 nearside, hypotube (hypotube) of slotting, such as
Screw slotting hypotube, to provide the torsional rigidity of catheter shaft 12 and/or pushing away property during use.Support 40 can be around sacculus
The body part 52 of structure 20 positions to be delivered to target location.
Conduit 10 may be configured to advance so that the remote position being delivered in patient's vascular system on wire 22.Example
As, in some cases, conduit 10 can be configured with the single operation personnel of guidewire lumen and change (SOE) conduit, this wire
Tube chamber distally port 26 extends to be positioned at the relatively short distance of balloon structure 20 nearside and the nearside in the distally of hub assembly 14 is led
Line cap 28.In this kind of structure, wire 22 can extend across the guidewire lumen between distal port 26 and proximal port 28, and
Extend to the near-end 16 of catheter shaft 12 along the outside of catheter shaft 12 at the nearside of proximal port 28.In other cases, conduit
10 can be configured with (OTW) conduit on the line of guidewire lumen, this guidewire lumen distal end portion at the distal top of conduit 10
Mouthfuls 26 extend through the whole length of catheter shaft 12 to the proximal guidewire port 30 in hub assembly 14.Fig. 1 show in phantom tool
There is this kind of structure of the proximad extension of wire 22.It is noted that in the case of conduit 10 is SOE conduit, hub assembly
14 may not include proximal guidewire port 30, and/or in the case of conduit 10 is OTW conduit, proximal guidewire port 28 can not be deposited
?.In other situation, conduit 10 can be configured to fixing wire conduit, and it has the handling of farthest side scope forming conduit 10
Line part.
The inflation port 34 that catheter shaft 12 may also include from hub assembly 14 extends to the inflation tube chamber within balloon structure 20.
Inflation tube chamber may be configured to, during medical procedure, inflation fluid is delivered to balloon structure 20 so that balloon structure 20 or
Its part inflates.In some cases, catheter shaft 12 can include that the inflatable part with the isolation of balloon structure 20 becomes fluid even
Logical multiple inflation tube chambers so that the unitary part of balloon structure 20 can inflate independently.
In certain embodiments, catheter shaft 12 or its part can include outer tubular member and extend through outer tubular member and
Limit the inner tubular element of guidewire lumen.Space between inner tubular element and outer tubular member can limit inflation tube chamber.At this
In class embodiment, main pipe axle 12 is configured so to the nearside waist of balloon structure 20 and is fixed to the far-end of outer tubular member
On, and the distally waist of balloon structure 20 is fixed on the far-end of inner tubular element, thus extend through the interior of balloon structure 20
Portion.
In other embodiments, catheter shaft 12 or its part can be the extrusion axle having multiple segment dislocation wherein.Example
As, extrusion axle can include the be arranged side by side guidewire lumen extended and inflation tube chamber.In this type of embodiment, main pipe axle 12 can
It is configured so that the nearside waist of balloon structure 20 is fixed to extrude in a part for axle, and the distally waist of balloon structure 20 is solid
Fixed to extruding another part of axle or from the tubular part that it extends, thus extend through the inside of balloon structure 20.
Conduit 10 may also include from the distally extending distal top 38 of balloon structure 20.Distal top 38 can have extension
Therebetween through and lead to the tube chamber of distal port 26 of its far-end to receive the wire 22 that distally port 26 extends.At some
In the case of, distal top 38 can be atraumatic top, such as, is similar to be provided with typical angioplasty balloon conduit
The flexible soft top on top.But, in other embodiments, distal top 38 may be configured to be easy to pierce through and/or cut
The organized layer of blood vessel.Such as, distal top 38 can include sharp keen, rigidity and/or pierce through feature.In one embodiment,
As shown in fig. 1, distal top 38 can include the distal side edge being at an angle of (or dihedral), thus distad top 38 provides sharp keen
Cutting or pierce through edge.
As described above, weight admittance pipe 10 can be stent delivery catheter 10, and it is configured to be delivered to be formed at by support 40
Inner membrance underpass in tube wall is to get around obturation.As used herein, term " support " is intended to include support, cover type support, prop up
Frame graft, graft and for implantation in body passageway with support path other expandable type prosthetic appliance.Support
Can be Automatic-expanding, launch (such as, by the inflation of sacculus) by inner radial power, or Automatic-expanding and expandable type
The combination of sacculus.
Support 40 or its part can be formed by bioabsorbable material.Some exemplary bio absorbable metal materials include
Ferrum magnesium alloy.Some exemplary bio can absorb polymeric material and include polyactide (PLA), PLLA (PLLA), poly-D-
Lactide (PDLA), PGA (PGA), polycaprolactone, polydioxanone, and tyrosine Merlon.United States Patent (USP)
Numbers 7,699,887;7,637,940;7,594,928;Some exemplary bio bioabsorbable stent structures are disclosed in 6,719,934
Making, the disclosure of which is integrally incorporated herein with it by quoting.
In certain embodiments, support 40 may be included in remote chamber (i.e., radially) surface and/or the tube chamber of support 40
Cover layer on (i.e., radially inward) surface, such as, Poly(D,L-lactide-co-glycolide (PLGA) film of biological absorbable.
Cover layer can produce the interface of the less wound between vascular tissue and support 40 and/or strengthen the natural tissues around support 40
Regrowth.In some cases, cover layer comparability is in forming the material of supporting structure self with different speed (such as, more
Soon or slower) absorb.In addition or as alternative, the cover layer on surface, remote chamber can produce smooth tube chamber so that once Additional medical
Device and the implantation of medical treatment device structure just pass through support 40 and advance.
In some cases, prop up rack overlays can include promoting the lubricant of tissue growth and/or biological coating and/
Maybe can include for being delivered to target location and subsequently from the therapeutic agent of coating eluting.
Term " therapeutic agent ", " medicine ", " bioactivator ", " medicine ", " forms of pharmacologically active agents " and other relative terms
Can be used interchangeably in the text, and include gene therapeutic agents, non-genomic therapeutic agent, and cell.Therapeutic agent can be used alone
Or be applied in combination.The therapeutic agent implant of relative broad range can use together with assembly of the invention, and its Chinese materia medica is effectively measured and can be held
Change places and determined by those skilled in the art, and finally such as depend on disease to be treated, the character of therapeutic agent self, dosage form
Introduce tissue therein, etc..
Some specific benefit agent include antithrombotic agents, anti-proliferative agent, antiinflammatory, metastasis agent, affect extracellular base
Matter produces and the preparation of tissue, antitumor agent, antimitotic agent, anesthetis, anticoagulant, vascular cell growth promoter, arteries and veins
Solencyte growth inhibitor, cholesterol reducing agent, vasodilation, and the preparation of interference endogenous vasoactive mechanism.
More specifically preparation include paclitaxel, sirolimus, everolimus, tacrolimus, Epo D, dexamethasone, female two
Alcohol, halofuginone hydrobromide, cilostazol, geldanamycin, ABT-578, (Abbott Laboratories pharmaceutical factory, Abbott Laboratories), a bent ground
That, liprostin, Actinomcin D, Resten-NG, Ap-17, abciximab, clopidogrel, ridogrel, β-blocking-up
Medicine, bARKct inhibitor, phospholamban inhibitor, and Serca 2 genes/proteins matter, resiquimod, imiquimod (and
Other imidazole quinoline immune response modifier), human Apolipoprotein (such as, AI, AII, AIII, AIV, AV etc.), vascular endothelium
Somatomedin (such as, VEGF-2), and the derivant of previous formulations, etc..
Therapeutic agent for implementing the many of the present invention additional is selected from commonly assigned U.S. Patent Application Publication No.
2003/0236514 [0040th] to those described in [0046] section, and the complete disclosure of this application is accordingly by quoting also
Enter.
Support 40 can include radiopaque element or include radiopaque material, to allow to utilize fluoroscopic equipment
Or other imaging technique makes the placement of support 40 visualize.Such as, the polymeric material forming support 40 can include iodine, or such as tungsten
Or the metal dust of barium is dispersed in the polymeric material of formation support 40 to provide the radio-opaque of expected degree to support 40.
Support 40 can be positioned in balloon structure 20 so that support 40 holds the body part of inflatable formula balloon structure 20
52, the distally anchor portion 60 of the most inflatable formula balloon structure 20 is positioned at the distally of support 40 and inflatable formula balloon structure
The nearside anchor portion 62 of 20 is positioned at the nearside of support 40.In some cases, the distally anchor of inflatable formula balloon structure 20
Determine part 60 to may be configured to launch and/or inflatable formula balloon structure 20 in a part for the true tube chamber of blood vessel in inaccessible distally
Nearside anchor portion 62 may be configured to launch in a part for the true tube chamber of blood vessel of inaccessible nearside, with at support 40 in interior
The period grappling weight admittance pipe 10 launched in film underpass is in order to avoid accidental movement.
As shown in fig. 1, in some cases, body part 52 can be dilating sacculus 50, and distally anchor portion 60 can
For between the distally waist of body part 52 and dilating sacculus 50 extend, the distal cone part 54 of dilating sacculus 50, and/
Or nearside anchor portion 62 can be extension, dilating sacculus 50 between the nearside waist of body part 52 and dilating sacculus 50
Nearside conical section 56.
Distally anchor portion 60 and/or nearside anchor portion 62 can the most really be dimensioned and configured to weight admittance pipe 10
It is anchored in vascular system, to use the period of (such as, launching) to prevent including support 40 in inner membrance underpass at support 40
Unexpected dislocation in film underpass.
Such as, as shown in fig. 1, inflate so that support 40 is launched into the inflation structure of deployment configuration at body part 52
In, the external diameter that the distally anchor portion 60 of inflatable formula balloon structure 20 has in inflation structure can launch more than support 40
External diameter in structure.Therefore, when support 40 launches against the tube wall tissue limiting inner membrance underpass, distally anchor portion 60
Diameter is significantly greater than the deployment diameter of support 40, to prevent distally anchor portion 60 from the true tube chamber in inaccessible distally to closely
Side is displaced in inner membrance underpass.
Similarly, as shown in fig. 1, inflate so that support 40 is launched into the inflation structure of deployment configuration at body part 52
In, the external diameter that the nearside anchor portion 62 of inflatable formula balloon structure 20 has in inflation structure can launch more than support 40
External diameter in structure.Therefore, when support 40 launches against the tube wall tissue limiting inner membrance underpass, nearside anchor portion 62
Diameter is significantly greater than the deployment diameter of support 40, to prevent nearside anchor portion 62 from the true tube chamber of inaccessible nearside to far
Side is displaced in inner membrance underpass.
Additionally, the length forming the distal cone part 54 of distally anchor portion 60 can be to the distal extension of support 40 from propping up
The distance of at least the 20% of at least 10% or length of the length of the support 40 that the near-end of frame 40 records to the far-end of support 40.Nearside
Conical section 56 can use similar fashion to extend from support 40 proximad.Such as, the nearside cone of nearside anchor portion 62 is formed
The length of part 56 can extend the length of the support 40 recorded from the near-end of support 40 far-end to support 40 to the nearside of support 40
The distance of at least the 20% of at least 10% or length of degree.Therefore, the support 40 of the length for having about 20 millimeters, at some
In the case of, distal cone part 54 and/or nearside conical section 56 can extend over about 2 millimeters, the end of support 40 to about
4 millimeters.
Inflatable formula balloon structure 20 be configured so to be formed the distal cone part 54 of distally anchor portion 60 and/or
The nearside conical section 56 forming nearside anchor portion 62 can be enough to make support 40 radially open up being inflated to by body part 52
Inflate at least in part before being split into deployment configuration.Such as, distal cone part 54 and/or nearside conical section 56 may be configured to
Launch at lower pressures compared to body part 52 so that when the pressure in inflatable formula balloon structure 20 increases, far
Side conical section 54 and/or nearside conical section 56 initially inflate radially to launch it at support 40 in inner membrance underpass
Front by inner membrance underpass grappling inflatable formula balloon structure 20, and therefore grappling conduit 10.
Fig. 2 shows the constructive alternative of the distal part of weight admittance pipe 10.As shown in Figure 2, weight admittance pipe 10 includes peace
The inflatable formula balloon structure 120 being contained in the distal part of catheter shaft 12.
Support 40 can be positioned in balloon structure 120 so that support 40 holds the body of inflatable formula balloon structure 120
Points 152, the distally anchor portion 160 of the most inflatable formula balloon structure 120 is positioned at the distally of support 40 and inflatable formula ball
The nearside anchor portion 162 of capsule structure 120 is positioned at the nearside of support 40.In some cases, inflatable formula balloon structure 120
Distally anchor portion 160 may be configured to launch and/or inflatable formula in a part for the true tube chamber of blood vessel in inaccessible distally
The nearside anchor portion 162 of balloon structure 120 may be configured to launch in a part for the true tube chamber of blood vessel of inaccessible nearside, with
The period grappling weight admittance pipe 10 that launches in inner membrance underpass at support 40 is in order to avoid accidental movement.
As shown in Figure 2, body part 152 can be dilating sacculus 150, and distally anchor portion 160 can be at catheter shaft
The single anchoring balloon 166 in dilating sacculus 150 distally it is positioned on 12.In this kind of embodiment, dilating sacculus 150 can be with extension
Through catheter shaft 12 first inflation tube chamber communication, and anchoring balloon 166 can with extend through the second of catheter shaft 12
Inflation tube chamber communication, therefore allows anchoring balloon 166 to inflate independent of dilating sacculus 150.In other cases, expansion
Both sacculus 150 and anchoring balloon 166 can be with single inflation tube chamber communication, and wherein anchoring balloon 166 is configured to make
Inflate at least in part before dilating sacculus 150 inflation.Such as, anchoring balloon 166 may be configured to exist compared to dilating sacculus 150
Inflate under lower inflation pressure.
Being similar to balloon structure 20, nearside anchor portion 162 can be the nearside at body part 152 with dilating sacculus 150
Extend between waist, the nearside conical section 156 of dilating sacculus 150.Dilating sacculus 150 may also include and is positioned at the remote of support 40
The distal cone part 154 of side, it can help to grappling weight admittance pipe 10.
Distally anchor portion 160 and/or nearside anchor portion 162 can the most really be dimensioned and configured to weight admittance pipe
10 are anchored in vascular system, to use the period of (such as, launching) to prevent support 40 from existing in inner membrance underpass at support 40
Unexpected dislocation in inner membrance underpass.
Anchoring balloon 166 can be and the parts of dilating sacculus 150 isolation, or anchoring balloon 166 can be dilating sacculus 150
Distal extension portion, wherein the central waist 170 of balloon structure 120 is fixed on catheter shaft 12 be positioned at dilating sacculus 150 and grappling
Between sacculus 166.
Fig. 3 shows another constructive alternative of the distal part of weight admittance pipe 10.As shown in Figure 3, weight admittance pipe 10 wraps
Include the inflatable formula balloon structure 220 in the distal part being arranged on catheter shaft 12.
Support 40 can be positioned in balloon structure 220 so that support 40 holds the body of inflatable formula balloon structure 220
Points 252, the distally anchor portion 260 of the most inflatable formula balloon structure 220 is positioned at the distally of support 40, and inflatable formula ball
The nearside anchor portion 262 of capsule structure 220 is positioned at the nearside of support 40.In some cases, inflatable formula balloon structure 220
Distally anchor portion 260 may be configured to launch and/or inflatable formula in a part for the true tube chamber of blood vessel in inaccessible distally
The nearside anchor portion 262 of balloon structure 220 may be configured to launch in a part for the true tube chamber of blood vessel of inaccessible nearside, with
The period grappling weight admittance pipe 10 that launches in inner membrance underpass at support 40 is in order to avoid accidental movement.
As shown in Figure 3, body part 252 can be dilating sacculus 250, and distally anchor portion 260 can be at catheter shaft
The single anchoring balloon 266 in dilating sacculus 250 distally it is positioned on 12.In this kind of embodiment, dilating sacculus 250 can be with extension
Through catheter shaft 12 first inflation tube chamber communication, and anchoring balloon 266 can with extend through the second of catheter shaft 12
Inflation tube chamber communication, therefore allows anchoring balloon 266 to inflate independent of dilating sacculus 250.In other cases, expansion
Both sacculus 250 and anchoring balloon 266 can be with single inflation tube chamber communication, and wherein anchoring balloon 266 is configured to make
Inflate at least in part before dilating sacculus 250 inflation.Such as, anchoring balloon 266 may be configured to exist compared to dilating sacculus 250
Inflate under lower inflation pressure.
Being similar to balloon structure 20, nearside anchor portion 262 can be the nearside at body part 252 with dilating sacculus 250
Extend between waist, the nearside conical section 256 of dilating sacculus 250.Dilating sacculus 250 may also include and is positioned at the remote of support 40
The distal cone part 254 of side, it can help to grappling weight admittance pipe 10.
Distally anchor portion 260 and/or nearside anchor portion 262 can the most really be dimensioned and configured to weight admittance pipe
10 are anchored in vascular system, to use the period of (such as, launching) to prevent support 40 from existing in inner membrance underpass at support 40
Unexpected dislocation in inner membrance underpass.
Anchoring balloon 266 can be and the parts of dilating sacculus 250 isolation, and compliant member (such as, metal hypotube 280,
Formed therein which multiple notch or otch 282 to provide the lateral flexibility of desired amount to hypotube 280) can be at dilating sacculus
Extend between 250 and anchoring balloon 266.The distally waist of dilating sacculus 250 can be fixed in hypotube 280, and anchoring balloon
The nearside waist of 266 can be fixed in hypotube 280.The hypotube extended between dilating sacculus 250 and anchoring balloon 266
280 or other compliant member can provide sufficiently flexible so that dilating sacculus 250 can be in inner membrance underpass by conductive pipe axle 12
Location and inflation, and anchoring balloon 266 positions and inflates in the true tube chamber of blood vessel in inaccessible distally.
In some cases, utilize chronic total occlusion (CTO) that medical treatment device passes in inaccessible such as vessel lumen with
Make vascular heavily logical be probably unexpected, difficulty or impossible.In such cases, it is possible to by using weight admittance pipe
The inner membrance under type of 10 makes blood vessel the most logical.Therefore, Fig. 4 to Fig. 8 shows for using weight admittance pipe 10 to make by inaccessible 90
The aspect of the illustrative methods that the blood vessel 80 of blocking heavily leads to.
Blood vessel 80 is generally of three organized layers, namely innermost layer or theca interna (that is, inner membrance) 82, intermediate layer or middle level
(that is, middle film) 84, and outermost layer or theca externa (adventitia) 86, wherein middle level 84 be positioned at theca interna 82 and theca externa 86 it
Between.Theca interna 82 is the endothelial layer of tube chamber 88 liner of vascular 80, and the connective tissue loosened by major part is constituted
Subendothelial layer.Middle level 84 is the Musclar layer mainly formed by smooth muscle cell circumferentially.Form the outer layer of tube wall 80
The loose connective tissue that theca externa 86 is mainly made up of fibroblast and the collagen fiber being associated is formed.
As shown in Figure 4, the inner membrance underpass in the wall of blood vessel 80 can initially be set up to get around inaccessible 90.Such as institute in literary composition
With, inner membrance underpass or space are the space between theca interna 82 and the theca externa 86 produced in tube wall 80, such as, Jing Guoguan
The organized layer of wall 80 cuts.Such as, wire 22 can initially travel across the tube chamber 88 of vascular 80 and arrives and block the closing of tube chamber 88
The position of the near-end nearside of plug 90.Then wire 22 can advance and outwards pierce through inner membrance with the position of the near-end nearside inaccessible 90
Layer 82 and enter in tube wall 80.In the case of the top of wire 22 is between theca interna 82 and theca externa 86, wire 22 can
Subintimal mode is used to advance the most further, to produce space under inner membrance between theca interna 82 and theca externa 86.Lead
Line 22 can use inner membrance under type to advance, until the distal top of wire 22 is positioned at inaccessible 90 under the inner membrance produced in space
Distalis, such as, by cutting the organized layer of tube wall 80.Once cross inaccessible 90, then wire 22 can be in the distally of inaccessible 90
Return in the true tube chamber being directed to blood vessel 80.Therefore, wire 22 can bypass inaccessible 90 and sets up the true pipe from inaccessible 90 nearsides
Can advance to the inner membrance lower channel of the true tube chamber in inaccessible 90 distally, additional medical treatment device on that channel with at vascular system in chamber
Medical procedure is performed in system.
It is appreciated that other technology can be implemented to utilize wire to get around inaccessible 90 under inner membrance, or otherwise
Walk around inaccessible 90 and set up inner membrance lower channel.Such as, if necessary, it is inserted into conduit or other tissue penetration device can be used for
Help to enter back into the true tube chamber in inaccessible 90 distally.
As shown in Figure 5, weight admittance pipe 10 then can on wire 22 from the true tube chamber 88 of inaccessible 90 nearsides distad
Advance under the inner membrance between theca interna 82 and theca externa 86 in space.The far-end of weight admittance pipe 10 can enter back into inaccessible 90 distally
True tube chamber to have support 40, balloon structure 20 body part 52 to may be positioned under inner membrance logical in location thereon
Road strides across obturation.Weight admittance pipe 10 can travel across space under inner membrance in delivery configuration, and such as, wherein balloon structure 20 is in
That release, stack structure and support 40 holds this balloon structure 20 stacked.
Weight admittance pipe 10 can be positioned such that the far-end of support 40 leads in the distally of inaccessible 90 and/or extends to vascular 80
The true luminal part in distally in, and the near-end of support 40 inaccessible 90 nearside lead to and/or extend to the nearside of vascular 80
In true luminal part.Therefore, the distally anchor portion 60 of balloon structure 20 can be inaccessible 90 remote being distally positioned at of support 40
In the true tube chamber of side, and the nearside anchor portion 62 of balloon structure 20 can be support 40 proximally-oriented at inaccessible 90 nearsides
In true tube chamber.
Once it is positioned to through inner membrance underpass, then the available inflation tube chamber being directed across catheter shaft 12 of balloon structure 20
Inflation medium inflate in inner membrance underpass, radially launch support 40, and therefore keep for walk around inaccessible 90 with
The path of rear blood flow.As shown in Figure 6, distally anchor portion 60 can inflate, with anchor in the true tube chamber 88 in inaccessible 90 distally
Surely include that the inflatable formula balloon structure 20 of the body part 52 below support 40 avoids unexpected proximad and moves, and support 40 exists
Inner membrance underpass launches the suitable placement keeping support 40 in inner membrance underpass.In addition or as alternative, nearside grappling
Part 62 can inflate in the true tube chamber 88 of inaccessible 90 nearsides, includes the sacculus of body part 52 below support 40 with grappling
Structure 20 avoids unexpected being distally moved, and support 40 launches to keep support 40 in inner membrance underpass in inner membrance underpass
Suitable placement.Such as, as can be from seen in fig. 6, distally anchor portion 60 can be against in the true tube chamber in inaccessible 90 distally
Membranous wall inflation and/or nearside anchor portion 62 can inflate against the endocardial wall of the true tube chamber of inaccessible 90 nearsides.
Distally anchor portion 60 inflatable being more than to diameter leads to the true tube chamber, inner membrance underpass of inaccessible 90 distally
The diameter of distal openings, and/or nearside anchor portion 62 inflatable to diameter more than lead to inaccessible 90 nearsides true tube chamber,
The diameter of the proximal open of inner membrance underpass.Therefore, in deployed condition, distally anchor portion 60 can be prevented to be drawn under inner membrance
In space, and/or nearside anchor portion 62 can be prevented to be drawn under inner membrance in space, thus balloon structure 20 is anchored on expectation
Position.Therefore, expandable type support 40 can have the deployment diameter in inner membrance underpass, and it is less than filling in inflation structure
The distally anchor portion 60 of expanding balloon structure 20 and/or the diameter of nearside anchor portion 62.
In some cases, distally anchor portion 60 and/or nearside anchor portion 62 can inflate inflatable formula sacculus knot
Inflate at least in part before the body part 52 of structure 20.Such as, distally anchor portion 60 and/or nearside anchor portion 62 can be
Support 40 under inner membrance in space by being inflated to diameter before the appreciable radial development of body part 52 and being respectively greater than in
The distal openings of film underpass and the diameter of proximal open.
In certain embodiments, distally anchor portion 60 and/or nearside anchor portion 62 may be configured to compared to body
52 are divided to launch at much lower pressure so that when the pressure in inflatable formula balloon structure 20 increases, distally anchor portion 60
And/or nearside anchor portion 62 initially passed through inner membrance underpass before making support 40 radially launch in inner membrance underpass
Inflation comes grappling inflatable formula balloon structure 20 and therefore grappling conduit 10.In addition or as alternative, distally anchor portion 60 and/
Or nearside anchor portion 62 is moldable or heat cure is to intended shape so that when inflatable formula balloon structure 20 is pressurizeed, distally
Anchor portion 60 and/or nearside anchor portion 62 passed through under inner membrance before making support 40 radially launch in inner membrance underpass
Path is inflated to be enough to the diameter of grappling inflatable formula balloon structure 20 and therefore grappling conduit 10.
In other embodiments, distally anchor portion 60 and/or nearside anchor portion 62 can be independent of inflatable formula sacculus
The inflation of the body part 52 of structure 20 inflates.Such as, individually inflation tube chamber can be with distally anchor portion 60, nearside grappling
Each connection in the body part 52 of part 62 and/or balloon structure 20.Therefore, distally anchor portion 60 and/or nearside
Anchor portion 62 can inflate before inflating the body part 52 of inflatable formula balloon structure 20.
Once support 40 launches, then balloon structure 20 can be released and conduit 10 can be return by proximad, so that support 40
With in space under radially deployment configuration stays inner membrance.In some cases, wire 22 may pass through space holding and guarantor under inner membrance
Hold in the true tube chamber in inaccessible 90 distally, with another therapentic part by additional medical device guiding to inaccessible 90 distally.
Once program completes, then wire 22 can take out from patient.Fig. 7 shows the support 40 radially launched, and it is directly being implanted
The inner membrance underpass 96 walking around inaccessible 90 is formed after the operative procedure of support 40.Support 40 can provide supporting inner membrance underpass 96
Horse structure, with keep open in case blood flow therebetween through.Inner membrance underpass 96 is true by the vascular 80 of inaccessible 90 nearsides
Luminal part is connected to the true luminal part of the vascular 80 in inaccessible 90 distally, to walk around inaccessible 90 generations bypass for blood flow
Road, and therefore make vascular 80 the most logical.
In some cases, can be biological absorbable support and/or the support including promoting the biological coating of tissue growth
40 may be configured to promote the natural tissues regrowth around support 40 within the period of a couple of days, a few weeks longer or several months, with along interior
Film underpass 96 produces shallow-layer theca interna.Such as, as shown in Figure 8, under support 40 implantable endocardial in space after time
During between, shallow-layer theca interna 92 can be formed to limit inner membrance underpass 96.In other words, circumference shallow-layer theca interna 92 can be from leading to
The proximal open of inner membrance underpass 96 is formed at the tube chamber table of inner membrance underpass 96 to the distal openings leading to inner membrance underpass 96
On face.Such as, as can see from the cross sectional view of Fig. 8 A, circumference shallow-layer theca interna 92 can produce and limit blood vessel 80
True tube chamber 88 internal film tissue's layer 82 and the adventitial tissue layer 86 of blood vessel 80 between.In some cases, in circumference shallow-layer
Film layer 92 may pass through the compromised layer of tissue 84 of blood vessel 80 and produces.Therefore, shallow-layer theca interna 92 can be by the true pipe limiting blood vessel 80
The tissue of the compromised layer of tissue 84 between internal film tissue's layer 82 and the adventitial tissue layer 86 of blood vessel 80 in chamber 88 is held.
In certain embodiments, support 40 or its part can be biological absorbable so that support 40 can be in certain time
Period is absorbed by the health of patient, thus leaves the shallow-layer inner membrance of the luminal surface forming the inner membrance underpass 96 walking around inaccessible 90
Layer 92.Therefore, during certain time in, such as, a couple of days, a few weeks longer or several months, support 40 solubilized with neighbouring inaccessible
True tube chamber 88 produces the natural tissues of circumference shallow-layer theca interna 92 and leaves the functional vascular lumen walking around inaccessible 90.
Those skilled in the art is it will be recognized that the aspect of present disclosure can be presented as except the described herein and spy of conception
Determine the various ways outside embodiment.Therefore, can be without departing from scope of the present disclosure as described in claims
With the change made in the case of spirit in form and details.
Claims (9)
1. heavily lead to a conduit tube component, described heavy logical conduit tube component bag for walk around that the obturation in blood vessel sets up inner membrance underpass
Include: from the elongated catheter shaft that hub assembly is distally extending；
The inflatable formula balloon structure being arranged in the distal part of described catheter shaft, described inflatable formula balloon structure is configured to
Utilize via extend through described catheter shaft inflation tube chamber be delivered to described inflatable formula balloon structure inside fluid from
Structure of releasing is expanded to inflation structure；
Hold the support of the body part of described inflatable formula balloon structure, the distally anchor of wherein said inflatable formula balloon structure
Surely it is partially located in the distally of described support, and the central waist of described inflatable formula balloon structure is fixed to described elongated lead
The body part of described inflatable formula balloon structure and the distally anchor portion of described inflatable formula balloon structure it is positioned on pipe axle
Between；
Wherein, the distally anchor portion of described inflatable formula balloon structure is configured at the blood vessel distally of described obturation, described
True luminal part in launch, with heavy admittance pipe described in the period grappling that launches in described inner membrance underpass at described support
Assembly is in order to avoid accidental movement.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that the distally anchor of described inflatable formula balloon structure
The external diameter that fixed part has in described inflation structure is more than the external diameter of the described support being in deployment configuration.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that described support has the near-end from described support
The length recorded to the far-end of described support, wherein, the distally anchor portion of described inflatable formula balloon structure is at described support
Distal extension described in support length at least 10% distance.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that described support has the near-end from described support
The length recorded to the far-end of described support, wherein, the distally anchor portion of described inflatable formula balloon structure is at described support
Distal extension described in support length at least 20% distance.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that the distally anchor of described inflatable formula balloon structure
Fixed part can inflate independent of the inflation of the body part of described inflatable formula balloon structure.
Heavy logical conduit tube component the most according to claim 5, it is characterised in that described distally anchor portion is anchoring balloon,
And described body part is the dilating sacculus being different from described anchoring balloon.
Heavy logical conduit tube component the most according to claim 6, it is characterised in that described heavy logical conduit tube component is additionally included in described
The fluting tubular part extended between dilating sacculus and described anchoring balloon.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that described inflatable formula balloon structure includes location
At the nearside anchor portion of the nearside of described support, described nearside anchor portion be configured to described obturation nearside, described
Launch in the true luminal part of blood vessel, with the most logical described in the period grappling that launches in described inner membrance underpass at described support
Conduit is in order to avoid accidental movement.
Heavy logical conduit tube component the most according to claim 1, it is characterised in that described body part is dilating sacculus, and
Described distally anchor portion is the distal cone part of described dilating sacculus.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201161568903P | 2011-12-09 | 2011-12-09 | |
| US61/568,903 | 2011-12-09 | ||
| US61/568903 | 2011-12-09 | ||
| PCT/US2012/068369 WO2013086271A1 (en) | 2011-12-09 | 2012-12-07 | Subintimal recanalization with bio-absorbable stent |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN103974676A CN103974676A (en) | 2014-08-06 |
| CN103974676B true CN103974676B (en) | 2016-12-07 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201280060585.5A Active CN103974676B (en) | 2011-12-09 | 2012-12-07 | Utilize under the inner membrance of biological absorbable support the most logical |
Country Status (6)
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| US (2) | US9302084B2 (en) |
| EP (1) | EP2787935B1 (en) |
| JP (1) | JP6118335B2 (en) |
| CN (1) | CN103974676B (en) |
| AU (1) | AU2012347644B2 (en) |
| WO (1) | WO2013086271A1 (en) |
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- 2012-12-07 US US13/707,734 patent/US9302084B2/en active Active
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- 2012-12-07 JP JP2014546106A patent/JP6118335B2/en active Active
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2016
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|---|---|
| AU2012347644B2 (en) | 2017-04-20 |
| CN103974676A (en) | 2014-08-06 |
| JP2015500099A (en) | 2015-01-05 |
| US9302084B2 (en) | 2016-04-05 |
| WO2013086271A1 (en) | 2013-06-13 |
| EP2787935B1 (en) | 2018-03-07 |
| AU2012347644A1 (en) | 2014-06-19 |
| US20160175571A1 (en) | 2016-06-23 |
| US10716923B2 (en) | 2020-07-21 |
| EP2787935A1 (en) | 2014-10-15 |
| JP6118335B2 (en) | 2017-04-19 |
| US20130150880A1 (en) | 2013-06-13 |
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